nursing

This book is a great textbook of emergency medicine, and I've chosen it over others simply because it's comprehensive without the useless drivel. Each section includes the necessary anatomy and pathophysiological considerations for the respective disoders. The subset of conditions are mentioned with just enough facts to understand the morbidity to treat it. The pictures, diagrams, algorithmic flow-charts, and drug regimens are a nice compliment, however, most of your clinical experience is going to come from interships and residency, so to assume this book is all you'll need to get by in EM is crazy. I still think it's the best out there to read before putting your mind to work.

*Emergency Medicine, A Comprehensive Study Guide* has long been a well-regarded standard emergency text, useful in day-to-day practice as well as for board preparation. This new edition has advanced the enlightened 'evidence-based recommendations' for changes in practice patterns, however, the lack of editorial control has resulted in a book packed with conflicting information. Each chapter is written by a different consultant, and unfortunately not all of them are up on this concept... we therefore get a series of conflicting statements when there is overlap in topics, and there is no attempt to reconcile this variability. Admittedly, opinions in much of medicine do vary; but outright conflict within a few pages in a standard text without discussion does harm to credibility.

Further loss of editorial control is also evident on a close read. It is apparent that a spell-checker was used for proof-reading (substitutions of the nature of "week" for "weak" abound) and in some areas clinical formulae have been mis-stated -- example: calculation of effective osmolarity, pg. 1341 (though correct elsewhere in the book). The index seems somewhat disorganized, with references to isolated appearance of a word (example: see *first* reference listing to "hyperglycemia"... certainly not the definitive source in the text). This problem is not isolated.

The book has expanded by approximately 500 pages over the 4th edition, totalling more than 2000 pages. Its size makes it unwieldly to read or carry; it should have been separated into 2 volumes. Even with that expansion, much useful information is missing. Though descriptions of EKG abnormalities in advanced electrolyte disturbance are adequately described, it certainly would have been an informational asset to actually include a picture of such characteristic tracings. Dermatology is similarly poorly pictured -- there are only 8 pages of color illustrations in the text, with nearly 2 pages wasted on 1)technique of foreign body removal (not needed in color) 2)a color demonstration of SPECT data -- well outside the range of information needed for the E.M. specialist, and not definitive, besides. Even worse, the illustrations interspersed in the dermatology section are simply black and white copies of the color text -- providing only suboptimal repetition.

Bottom line: the *Comprehensive Study Guide* has been, and remains, a valuable text for an overview of the practice of emergency medicine; but either keep your 4th edition, or wait for the 6th.

Do you know the true meaning of the words "Study Guide?" Well, what that means is that you must be able to achieve a passing score on the American Board of Emergency Medicine's Certifying Exam by studying nothing more than this book. And I believe it, since I have passed it twice studying basically nothing more than this book. While it lacks the broad panache of the "other" two volume tome, the idea that you can pass the certifying exam by memorizing this huge book is, well, it's sexy.